Evaluating the Clinical and Cost-effectiveness of New Medicines

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Every year a large number of new medicines receive marketing authorisation. It is the National Health Service (NHS) responsibility to decide whether the additional cost of purchasing these medicines is justified by the likely benefit to patients. For this reason, a multi-disciplinary activity known as the health technology assessment (HTA) has been created. In the UK, HTA mainly focuses on the clinical and cost-effectiveness of new medicines.

In this essay it was discussed the processes through which HTA appraise new medicines and how the different policy makers within the UK use the most available evidence-based information to decide which technologies are most effective and appropriate for use.

Before a new medicine can be licensed for use in the UK, a long-lasting research (12 years) needs to be carried out. During this time each new medicine is assessed for its safety, quality and efficacy. A pharmaceutical company can apply for a marketing authorisation either through Medicines and Healthcare products Regulatory Agency (MHRA) or European Medicines Agency (EMA). MHRA is an authority in the UK that is responsible for the safety of medicines and medical devices while EMA evaluates the use of medicinal products across all member states within the European Union.

Once a medicine has been licensed, is being assessed for its clinical and cost-effectiveness for use in the NHS. In Scotland there is a national consortium of representatives of local drug and therapeutics committees known as the Scottish Medicines Consortium (SMC). SMC uses transparent decision making processes in order to assess the value of a new medicine. As soon as a medicine becomes available for use, SCM decides whether this medicine should be recommended in the...

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... proposed by the pharmaceutical companies and makes a recommendation to SMC prior to be accepted or not. Where PAS is approved for a medicine the SMC has to consider the offered discount. On the other hand, where a PAS is not considered achievable, the SMC estimates the value of the medicine on its standard cost. In that case the pharmaceutical company has the right to resubmit a revised PAS for acceptance.

Issues on the complexity of PAS processes have been raised. Risk sharing schemes would be of less inconsistency if a more straightforward process would be carried out in order to make a discount for expensive drugs.

All recommendations above have been made in order to make an open and transparent system where everyone will have the right to contribute on the decision making process regarding the clinical and cost effectiveness of newly licensed medicines.

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